RCP 300 > final > Flashcards

final Flashcards

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1
Q

drug names

A

chemical: Describes molecular structure

generic:US adopted name
Simpler version of chemical name

trade: Given by manufacture for marketing purposes

official:Approved for use and listed in official pharmacopoeia

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2
Q

wha branch of government is involved in approving new drugs for use, important drug laws

A

FDA,

1906 pure food and drug act
1938 food drug and cosmetic act

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3
Q

what are the benefits of inhaled aerosolized agents

A

-smaller dose
-fewer side effects
-rapid onset
-target respiratory system
-painless,relatively safe

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4
Q

define tolerance

A

decreasing intensity of response to a drug over time

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5
Q

define tachyphylaxis

A

Rapid decrease in responsiveness to a drug

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6
Q

define agonist

A

chemical or drug that binds to a receptor and creates and effect on the body

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7
Q

define antagonist

A

chemical or drug that binds to a receptor but does not create an effect on the body,it blocks the receptor site from, accepting an agonist

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8
Q

explain first pass

A

drugs taken orally=little drug reaching systemic circulation
reduces bioavailability
- get absorbed in stomach/intestine, metabolizes in liver, loses concentration

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9
Q

define parasympathetic

A

rest digest:
↓HR
miosis
↑motility/digestion activity
↑mucus/secretions
bronchoconstiction

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10
Q

define what happens when parasympathetic nervous system is overstimulated

A

SLUD
salivation,
lacrimation
urination
defecation

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11
Q

define sympathetic system

A

fight or flight:
-↑Hr
-↑BP
-↑RR
-dilated pupils: mydriasis
-↓motility
-bronchdilation

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12
Q

how is acetylcholine inactivated at the synapse

A

inactivated by enzyme: cholinesterase

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13
Q

what receptors are targets for bronchodilation in the lungs

A

-beta 2 receptors

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14
Q

what is the affect of beta blockers (propranolol) on albuterol therapy

A

they have an antagonist effect
-block the effects of albuterol

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15
Q

match the following together:
1. albuterol
2.levalbuterol
3. salmeterol
4. racemic epinephrine
with:
a. saba
b. laba
c. rescue
d. croup treatment

A
  1. albuterol: SABA, rescue
  2. levalbuterol:SABA, rescue
  3. salmeterol:LABA
  4. racemic epinephrine: croup treatment
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16
Q

side effects of continued nebulized albuterol

A
  • cardiac arrthmias
    -hypokalemia
    -hyperglycemia
    -tremor
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17
Q

what two medications make up DuoNeb(nebulizer)/ Combivent

A

ipratropium bromide and albuterol

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18
Q

name one short acting anticholinergic bronchodilator

A
  • ipratropium bromide (atrovent)
    -quick relief in COPD
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19
Q

name one long acting anticholinergic bronchodilator

A

-tiotropium bromide ( spirvia)
- once daily
-maintenance

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20
Q

common side effects of ICS (inhaled corticosteroids)

A

-oropharyngeal candidiasis (oral thrush)
-dysphonia (hoarseness)
-cough/ irritation

-others systemic:
HPA suppression
loss of bone density
growth restriction in children

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21
Q

define cromolyn

A

mast cell stabilizers
- prevent mast cell degranulation
, prevent them from releasing inflammatory substances that lead to asthma : histamine and leukotrienes

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22
Q

two examples of antileukotrienes

A

prophylactic controller drug

-montelukast(singular): common- 6 months +
oral: 4,5,10mg

-zalfirlukast (accolate)
oral: 10 mg bid children 5-11
20 mg bid 12+

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23
Q

general indications for cromolyn and anti-leukotriene agents

A

used in persistent mild,moderate, severe asthma

alternative to ICS in asthma requiring step 2 care

cromolyn used with infants and younger children as alternatives to ICS in asthma

can be used in combination with ICS to reduce the steriod dose

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24
Q

what is the mechanism of action of omalizumab (xolair)

A

bonds to IgE and stops IgE attachment to mast cells

*monoclonal antibody

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25
what is hypertonic saline used for
induce cough, and helps liquify secretions
26
define N acetylcysteine
- mucolytic: mucomyst -decrease viscosity of secretions: breaks down disulfide BONDs in mucus molecules making them less sticky and easier to expel *can be used acetaminophren overdose
27
which inhaled antibiotic are commonly used for cystic fibrosis
- tobramycin (tobi): management of chronic pseudomonas aeruginosa infection in CF -aztreonam ( cayston) improve symptoms in CF w p.aeruginosa infection
28
what is a major side effect of inhaled tobramycin
-tinnitus -voice alteration
29
what percentage of cardiac output goes into the kidneys
20-25%
30
which electrolyte imbalance from diuretics increase the risk of arrhythmias
hypokalemia
31
what is the first line vasopressor in septic shock
norepinephrine
32
what is the mechanism of action of digoxin
inotropic effect on myocardium-strengthens hearts ability to contract -reversibility inhibits the Na+/K+ atpase pump in cardiac muscle (more Ca++=more contraction)
33
clinical used of barbiturates
-induce sleep -seizure -anestesia induction -hypnotics
34
primary medical use of opioids
pain management mod- severe pain
35
main risk/side effects of opioid use
*respiratory depression others: constipation nausea vommiting antitussive effects high addictive
36
which medication reverses opioid overdose
naloxone (narcan)
37
what is general anesthesia
unconscious, needs airwasy support
38
what is conscious anestesia
pt reamin conscious -able to communicate and protect airway -improve pt comfort and outcome
39
non depolarizing NMBA
rocuronium: fast, 30-1 hr pancuronium:long duration, longer procedures that require extended muscle relaxation vecuronium:intermediate duration attracurium: short duration, inactivated by pH and temp stimulate most histamine
40
depolarizing NMBA
succinylcholine short acting paralysis : 60-90 seconds duration 10-15 mins -ideal for pt intubation
41
which muscle group regains function first after NMBA recovery
diaphragm first followed by: intercoastles abdomen extremities neck face eyelids (last to regain)
42
- what do Beta 2 adrenergic bronchodilators do
treat bronchoconstriction by relaxing smooth muscle in the airways
43
what do anticholinergic brochodilators do
block acetylcholine and prevent airway narrowing
44
what do methlxanthines do
increase cAMP levels to promotes bronchodilation -theophylline is common example
45
what do corticosteroids do
reduce inflammation and promoted bronchdilation (combine with LABA) often used for asthma and COPD
46
what do mucolytic agents do
break down thick mucus for easier clearance
47
what do diuretics do
promote urine production aid in removal of excess water commonly used to mange fluid overload- CHF, pulmonary edema
48
what do loop diuretics do
most potent diuretics, used to treat hypertension severe fluid retention in CHF , acute chronic renal failure -furosemide (lasix) most common
49
what electrolyte imbalance would for force Na+ to exchange for H+ resulting in metabolic alkalosis
low Cl or K+
50
electrolytes:
sodium potassium chloride bicarbs -hydrogen -calcium -magnesium
51
what do thiazide diuretics do
first line of treatment for mild hypertension -other CHF, idopathic hypercalciuria
52
what does potassium sparing diuretics do
block exchange of Na+ for K+ and H+, helps body keep potassium while getting rid of other fluids
53
what do osmotic diuretics do
-most common: mannitol: help reduce increased ICP, cerebral edema -treat acute renal failure by increasing osmotic pressure in kidneys removing fluid
54
NAVEL
Naloxone atropine vasopressin epinephrine lidocaine
55
what is the first line of therapy for hypotensive episodes
fluids
56
what do cardiogentic (positive inotropic) drugs do
strengthen muscular contraction, helps pump blood more effectively -digoxin -dobutamine -milrinone
57
what do vasopressors (vasoconstricting) drugs do
narrow blood vessels- vasoconstiction -norepinephrine -dopaine -phenylephrine -vasopressin -midofrine -epinephrine
58
what do antiarrhthmic drugs do
agents that help with irregular fast or slower heartbeats -stabilize electrical activity -atropine(bradycardia, cardiac resuscitation of asystole) -tachycardia: -lidocaine (ventricular arrythmias, surgery or MI) -amiodarone (ventricular/svt) -procainamide -adenosine(12-sec half life, flush immediately,term SVT)
59
what are sodium bicarbs and magnesium sulfate used for
sodium bicarbs- metabolic acidosis during cardiac arrest (keep ph>7.15) magnesium sulfate-tosades de pointes
60
kidneys:
-nephron-functional unit -urine output :30-60mL/hr
61
what can happen when vasopressors leak out vein
extravasastion -swlling -erthema -blistering -blanching -motting of skin
62
what are anxiolytics
meds that reduce anxiety benzadizepine -lams/pams
63
define local anesthetics
-numb specific areas to prevent pain -lidocaine
64
reversal of non depolarizing agents
acetylcholinesterase inhibitor
65
what are orphan drugs
rare diseases affecting <200000
66
define pharmacokinetics
what the body does to the drug
67
primary organ for excretion
kidney
68
primary organ of metabolism
liver
69
define pharacodynamics
what the drug does to the body
70
define pharmacogenetics
pt response to drugs due to hereditary difference
71
neuotransmitters for parasympathetic/sympathetic
acetycholine norepinephrine
72
define: parasympathomimetic parasympatholytic
parasympathomimetic: -cholinergic agent, mimics parasympathic systme parasympatholytic: -anticholinergic, blocks affects of parasympathic system
72
receptors for parasympathetic / sympathetic
para: M1: CNS M2: heart ↓hr M3: smooth muscle/submucosal gland-bronchoconstriction symp: A1- vessels- vasoconstriction B1: heart:↑HR B2:lungs- bronchodilation
73
define: sympathomimetic sympatholytic
sympathomimetic: -adrenergic agent, mimics sympathetic system sympatholytic: -antiadrenergic agent, blocks effect of sympathetic system
74
what is a direct acting cholinergic agent used in bronchial challenge test
methacholine-bronchoconstriction
75
primary inflammation cells for asthma and copd
asthma: mast cells , eosinophil COPD: neutrophils
76
asthmatic reaction phases
early: 15min-1hr=mast cells+eosinophils, release histamine lead to inflammation+mucus late: 6-8hrs, eosinophils+lymphocytes
77
what is pentamidine
nebupent antiprotozoal agent - treat pneumocystic pneumonia PCP
78
what are the two antiviral drugs
ribravirin ( virazole)- RSV :admin SPAG, 20mg 12-18hr/day, 3-7days zanamivir (relenza)-uncomp influenza
79
two antibacterial agents
tobramycin (tobi):amioglycoside aztreonam (cayston)
80
define mucoregulatory mucokinetic mucospissic mucolytic
mucoregulatory: reduce volume of mucus mucokinetic: increase cough or cilliary clearance of secretions mucospissic: increase viscosity of secretions mucolytic: breaks down plymers in secretions (thin mucus)
81
most common cause of dornase alfa
voice alteration
82
loop diuretics complications
hypokalemia ototoxicity
83
theophyline is derived from
tea leaves, coffee beans kola nut, cocoa seeds
84
drug administration
drug enter the body
RCP 300
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